CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Nemaha Valley Community Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $467
  • Cash Discount Price: $786
  • vs. Medicare Baseline: 1.92x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Nemaha Valley Community Hospital is $467. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $786. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.92x the Medicare baseline. Located in 1600 Community Dr, Seneca, KS.
Cash / Self-Pay
$786

Average discount available for prompt cash payment at this facility.

Insurance Median
$467

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)
Cash / Self-Pay: $786 (322%)
Insurance Median: $467 (192%)
Cash: $786 (322% of Medicare)
Ins. Median: $467 (192% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Humana $384 158%
Va Ccn - All Plans $384 158%
Aetna $388 - $742 159%
Celtic Comm Exch - All Plans $423 174%
Partners Direct Health - All Plans $454 186%
Blue Cross Blue Shield $481 197%
Multiplan - All Plans $786 322%
Midlands Choice - All Plans $829 340%
Health Partners - All Plans $829 340%

Consumer Guidance & Cost Commentary

For the ultrasound procedure of leg veins (duplex) at Nemaha Valley Community Hospital in Seneca, KS, the cash median price is $786.00, which is significantly lower than the facility's gross charge of $873.00. While the hospital's negotiated rates with insurance payers range from $384 to $829, patients with high-deductible plans may find that paying the cash price directly is more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount. It is important to note that the facility is a Critical Access Hospital in a rural area, and while the data does not provide specific county or state average comparisons for this specific code, patients should always verify if their specific insurance plan's negotiated rate is higher than the cash price before scheduling.

To ensure you are receiving the best possible rate, we recommend requesting an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, ask the billing department about "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if you pay in full upfront, effectively bypassing the administrative costs associated with insurance claims processing. If you choose to use insurance, remember that the allowed amount varies by payer, with Humana and VA plans at $384 and Aetna ranging from $423 to $742, so comparing these specific allowed amounts against your cash price is essential for determining the most economical path forward.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 Community Dr, Seneca, KS 66538
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals